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I've always had the same feeling about dentists. If they really fix your teeth, you wouldn't need their services anymore.

The logic goes for a lot of service type situations like auto-repair post-warranty period.



Which is, of course, an argument for single-payer healthcare. (Or even semi-centralized, insurance based healthcare, for that matter). A $BIGORG has both the firepower and the incentives to ensure that your bodyparts stay healthy at minimum expense.

An anecdote: Ads like "your dentist hates this simple trick" don't work at all in a single-payer system. People are just baffled as to why a doctor wouldn't want you to be healthy!


It's an argument for having dentists compete, as they do, and picking the one who does a good job.


It's not like a layman can have a good idea of whether a dentist has done a good job, except in cases where the job was clearly botched. People can't realistically make an informed choice based on dentist competence, so soft metrics like patient comfort and general bellyfeel dominate. Moreover, people hopefully don't need dental services very frequently, so gathering enough data takes a long time.


OK. But a single payer addresses none of those issues.


Well, it tries to. Whether or not it succeeds is the subject of lots and lots of debate, but single payer systems I'm aware of have accountability models driven by (usually public-sector) audits and quality controls that try to optimize for health outcomes. The rationale being that the payer (government) spends less overall, and is more likely to be supported (voted for), if the population has good health outcomes in areas that the government can influence via the healthcare system.


Paying and quality assessment don't need to be coupled. The government doesn't need to be paying for the healthcare in order to make recommendations aimed at improving health outcomes. It would probably be happy to swell its ranks by starting up a dental review board.

Though I'm not optimistic about either its ability to fund healthcare or assess its quality.


Single payer has many, many more data points from which to draw conclusions.


> I've always had the same feeling about dentists. If they really fix your teeth, you wouldn't need their services anymore.

Dental problems are two fold, genetic and habitual.

There are people who brush and floss 2x a day and have miserable teeth, their personal biome and genetics have screwed them.

Then there are people like me, I skipped the dentist for 2 years and when I went the dentist said my teeth looked perfect. (Though being on a keto diet for that time might have helped, one dentist I had said keto is the perfect diet for dental health! :) )


This makes sense as things like bread, if left in your teeth, eventually turn to basically sugar, and start working to dissolve your teeth.


> This makes sense as things like bread, if left in your teeth, eventually turn to basically sugar, and start working to dissolve your teeth.

This was in the early days of keto, back when you couldn't find any keto products at the store and it was just a small subreddit that spread by word of mouth.

I described my diet to my dentist (no carbs at all, no sugar, lots of green veggies, healthy meats and fats, all home cooked), and she instantly approved of it.

IMHO Keto has gone off the rails, no true scotsman and all of that. In the early days keto shared a lot of dietary stuff with paleo in regards to no processed ingredients, everything from scratch, and I think that made a real difference in how effective it was.

Before if I wanted keto ice cream I had to make keto ice cream. Now I can just buy it at every local grocery store. Well excess calories are still excess calories...

Also the prepackaged keto stuff isn't as satiating as from scratch keto food, and half of the benefit of keto is the food is supposed to be more satiating.

/rant


>If they really fix your teeth, you wouldn't need their services anymore.

Not really. A dentist fixing your dental cavity doesn't stop you from gettinga new one in 10 years.


This type of logic doesn't really hold for healthcare providers, at least not in the US. The licensing restrictions is how they make their money. The demand for service so far outstrips the supply of providers that they don't really need individual repeat business. They'll do just fine with positive word-of-mouth. In the specific case of dental care, there is also the problem that "fixing" the immediate problem generally can't fix the root cause, which is some combination of bad genetics and people constantly drinking loads of nearly pure sugar. As long as those things don't change, you'll keep coming back with new problems even if they fix the old ones.


> They'll do just fine with positive word-of-mouth.

Sometimes you don't even need that.

If you ever want to feel depressed, go to your city's subreddit and search for "what business will you never go to again?" I remember one popped up on my city's sub recently, and it made me incredibly thankful for my dentist. The sheer amount of shit some get away with (while having ritzy offices in expensive neighborhoods) is incredible. And sure, such a thread is bound to attract people who have had negative experiences, but the sheer quantity of complaints some places had (with nobody chiming in to defend them or say something to the effect of "I've never had any problems like that") spoke for itself.


That's silly. Do you also have the same feeling about carpenters, electricians and plumbers? If they fix something poorly you hire a different one next time.





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